Humans ; Smoking Cessation ; Smoking/adverse effects* ; Primary Health Care

INTRODUCTION

Tobacco smoking is one of the most significant preventable lifestyle risk factors, causing a wide range of diseases and causing harm to millions of people worldwide. Nicotine replacement treatment (NRT) and behavioral counseling have long been used to help people quit smoking. However, because pharmacologic and behavioral therapy only have a 22% to 45% success rate in smoking cessation, a systematic review and meta-analysis was conducted to evaluate ear acupuncture’s usefulness as an adjunct to nicotine replacement therapy and behavioral counseling for smoking cessation.

This systematic review only included randomized controlled trials which involved current smokers aged 19 years or older, and who were in the contemplation stage according to the Transtheoretical Model of Intentional Behavior of Change. The RevMan 5 software was used in the analysis of data. The primary outcome that was measured is the rate of continuous abstinence based on participant/patient report at the end of treatment and secondary outcome of the study was reporting of nicotine withdrawal symptoms.

Of the 1,661 identified records, only 2 studies were included (both RCTs) in the meta- analysis. The studies were rated with low to unclear selection bias and high risk of performance bias. The pooled estimates of effect were statistically significant in favor of ear acupuncture plus counseling (standard therapy), RR= 2.28, 95% CI 1.27, 4.08, p= 0.006, I2= 0%. Nicotine withdrawal symptoms were noted to be less pronounced in those who received the intervention of ear acupuncture even after 3 months post-treatment. The evidence was graded as low quality, indicating that more research is needed and would extremely likely have a significant impact on confidence in the estimate of effect.

The results of this systematic review and meta-analysis suggest that ear acupuncture produces an additive benefit on counseling (standard of care) as a means of smoking cessation. Future research should be conducted using RCTs of a high quality in order to address the substantial risk of bias that was present in the studies that were included and to improve the quality of the evidence.

Humans ; Electronic Nicotine Delivery Systems ; Prevalence ; Mental Disorders/epidemiology* ; Smoking/epidemiology* ; Perception

INTRODUCTION

Smoking is one of the biggest global public health problems. It is known that the use of tobacco can have detrimental effects on a person’s overall health. Thus, this study is geared towards determining the knowledge and attitude of medical residents about tobacco cessation.

The study determined the knowledge and attitudes of smoking cessation among VSMMC residents and assessed their understanding of the risks associated with tobacco use.

A descriptive cross-sectional research design was used employing an online survey of 171 medical residents from December 2022 to March 2023. An in-depth analysis of categorical variables related to demographic factors using chi-square and Fisher’s exact tests was subsequently done.

Most have average knowledge and a good knowledge foundation about tobacco cessation. The majority, primarily aged 25 to 34, single are more knowledgeable about quitting smoking and its benefits as well as the women, although statistically not significant in proportion of the knowledge base. Approximately 69% were nonsmokers, and 87.7% lacked training in tobacco cessation. Only 8.2% demonstrated poor knowledge of smoking cessation, while 91.8% had average to good knowledge. Knowledge levels did not significantly differ based on demographics, smoking status, or training, except for residency type. Generally, they have a positive attitude towards tobacco cessation and agreed that it is part of their responsibility to assist and motivate patients. They recognized the positive impact on healthcare provider-patient relationships, and the minority felt discomfort counseling patients. Most believed in the availability of time to provide advice, and some acknowledged potential patient resistance or viewed quitting smoking as an individual choice.

The significant difference in knowledge based on residency type emphasizes the necessity for interventions to fill knowledge gaps and suggest areas for targeted educational interventions. The findings also underscore the importance of early education, as evidenced by the majority obtaining training during medical school.

Humans ; Smoking Cessation ; Beijing/epidemiology* ; COVID-19/epidemiology* ; Pandemics/prevention & control* ; Smoking/epidemiology*

Humans ; Adolescent ; Pandemics ; Substance-Related Disorders/epidemiology* ; Smoking ; Ethanol ; Republic of Korea/epidemiology* ; Alcohol Drinking/epidemiology*

BACKGROUND: Epidermal growth factor receptor (EGFR) gene mutations are the most common driver mutations in non-small cell lung cancer (NSCLC). To prolong the survival of the patients, EGFR tyrosine kinase inhibitors (TKIs) resistance in NSCLC is a major challenge that needs to be addressed urgently, and this study focuses on investigating the mechanism of cigarette smoke (CS) induced Gefitinib resistance in NSCLC. METHODS: PC-9 and A549 cells were cultured in vitro and treated with 1 µmol/L Gefitinib for 4 h and 10% cigarette smoke extract (CSE) for 48 h. Western blot was used to detect Sirtuin 3 (Sirt3) and superoxide dismutase 2 (SOD2) protein expressions; DCFH-DA probe was used to detect intracellular reactive oxygen species (ROS); CCK-8 kit was used to detect cell activity, and EdU was used to detect cell proliferation ability. Sirt3 overexpression plasmid (OV-Sirt3) was transfected in PC-9 and A549 cells and treated with 1 µmol/L Gefitinib for 4 h and 10% CSE for 48 h after N-acetylcysteine (NAC) action. The expressions of Sirt3 and SOD2 were detected by Western blot; the ROS level in the cells was detected by DCFH-DA probe, and the cell activity was detected by CCK-8. RESULTS: CSE induced an increase in the 50% inhibitory concentration (IC50) of both PC-9 and A549 cells to Gefitinib (P<0.01) and enhanced the proliferation of PC-9 and A549 cells, suggesting that CS induced Gefitinib resistance in NSCLC. ROS was involved in CSE-induced Gefitinib resistance (P<0.05). CSE induced low expressions of Sirt3 and SOD2 (P<0.01), and Sirt3/SOD2 was associated with poor prognosis in lung cancer patients (P<0.05). OV-Sirt3 in PC-9 and A549 cells reversed CSE-induced Gefitinib resistance (P<0.05) and significantly reduced ROS production. NAC reversed CSE-induced Gefitinib resistance in PC-9 and A549 cells (P<0.05). CONCLUSIONS The ROS/Sirt3/SOD2 pathway is involved in CS-induced Gefitinib resistance in NSCLC.
Humans ; Gefitinib/therapeutic use* ; Carcinoma, Non-Small-Cell Lung/metabolism* ; Sirtuin 3/therapeutic use* ; Lung Neoplasms/metabolism* ; Reactive Oxygen Species/therapeutic use* ; Antineoplastic Agents/therapeutic use* ; Cigarette Smoking ; Sincalide/therapeutic use* ; ErbB Receptors/metabolism* ; Drug Resistance, Neoplasm/genetics* ; Cell Line, Tumor

Objective: To investigate the distribution of blood pressure and analyze the associated factors of blood pressure of the elderly with type 2 diabetes in Jiangsu Province. Methods: The elderly over 60 years old participants with type 2 diabetes in the communities of Huai'an City and Changshu City, Jiangsu Province were selected in this study. They were divided into two groups: taking antihypertensive drugs and not taking antihypertensive drugs. The demographic characteristics, such as age and sex, and relevant factors were collected by questionnaire. The systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured by physical examination. The percentile of SBP and DBP in each age group of men and women were described. The kernel density estimation curve was used to show the blood pressure distribution. The trend of blood pressure with age was fitted by locally weighted regression. The logistic regression model was used to analyze relevant factors of blood pressure. Results: A total of 12 949 participants were included in this study, including 7 775 patients in the antihypertensive drug group and 5 174 patients in the group without antihypertensive drugs. The SBP of participants was concentrated at 140-160 mmHg, and their DBP was concentrated at 75-85 mmHg. There were significant differences in the distribution of blood pressure among the subgroups of body mass index (BMI) and rural areas whether taking antihypertensive drugs and not. For participants aged under 80 years old, the SBP showed an increasing trend with age and the DBP showed a decreasing trend with age. Age, BMI ≥24 kg/m², fasting blood glucose ≥7.0 mmol/L, living in rural areas and no smoking were influencing factors of the elevated SBP; BMI ≥24 kg/m², male, living in rural areas, no smoking, drinking alcohol and not receiving drug hypoglycemic treatment were influencing factors of the elevated DBP. Conclusion: The SBP of older diabetic adults in Jiangsu Province is at a high level, and the distribution of blood pressure is significantly different between men and women in taking antihypertensive drugs group. The SBP presents a rising trend and the DBP is decreasing at the age of 60-80 years. The blood pressure level of this population are mainly affected by age, BMI, urban and rural areas, smoking.
Adult ; Aged ; Humans ; Male ; Female ; Middle Aged ; Aged, 80 and over ; Blood Pressure/physiology* ; Diabetes Mellitus, Type 2/epidemiology* ; Antihypertensive Agents/therapeutic use* ; Smoking ; Body Mass Index ; Hypertension/epidemiology*

Objective: To forecast mortality, age-standardized mortality, and probability of premature mortality from diabetes, and to simulate the impact of controlling risk factors by 2030 in China. Methods: We simulated the burden of disease from diabetes in six scenarios according to the development goals of risk factors control by the WHO and Chinese government. Based on the theory of comparative risk assessment and the estimates of the burden of disease for China from the Global Burden of Disease Study 2015, we used the proportional change model to project the number of deaths, age-standardized mortality, and probability of premature mortality from diabetes under different scenarios of risk factors control in 2030. Results: If the trends in exposures to risk factors from 1990 to 2015 continued. Mortality, age-standardized mortality, and probability of premature mortality from diabetes would increase to 32.57/100 000, 17.32/100 000, and 0.84% by 2030, respectively. During that time, mortality, age-standardized mortality and probability of premature mortality for males would all be higher than for females. If the goals of controlling risk factors were all achieved, the number of deaths from diabetes in 2030 would decrease by 62.10% compared to the predicted numbers based on the historical trends in exposure to risk factors, and the probability of premature mortality would drop to 0.29%. If only the exposure to a single risk factor were achieved by 2030, high fasting plasma glucose control would have the greatest impact on diabetes, resulting in a 56.00% reduction in deaths compared to the predicted numbers based on the historical trends, followed by high BMI (4.92%), smoking (0.65%), and low physical activity (0.53%). Conclusions: Risk factors control plays an important role in reducing the number of deaths, age-standardized mortality rate, and probability of premature mortality from diabetes. We suggest taking comprehensive measures to control relevant risk factors for certain populations and regions, to achieve the goal of reducing the burden of disease from diabetes as expected.
Male ; Female ; Humans ; Risk Factors ; Diabetes Mellitus/epidemiology* ; Mortality, Premature ; Smoking ; Cost of Illness ; China/epidemiology* ; Global Burden of Disease

Objective: based on summarizing the simulation and prediction of tobacco control measures across the globe and sorting out the various scenarios of tobacco control measures, the potential short-term effects of seven tobacco control measures in different scenarios were systematically analyzed. Methods: Until April 2022, PubMed, Embase, EconLit, PsychINFO, and CINAHL databases were used to retrieve literature about tobacco control measures simulation and prediction models across the globe. Inclusion and exclusion criteria were strictly followed. Meta-analysis for the potential short-term effects of seven tobacco control measures in different scenarios was performed using the R software. Results: A total of 22 papers covering 16 countries were selected. Five studies were conducted in the United States, three in Mexico, and two in Italy. There were all papers with the measures to tax increases, smoke-free air laws, and mass media campaigns, 21 papers with youth access restrictions, 20 with marketing restrictions, and 19 with cessation treatment programs and health warnings. The tax increases had diverse influences on the price elasticity of different age groups. The price elasticity in the age group 15-17 years was the highest, which was 0.044 (95%CI: 0.038-0.051). The potential short-term effects of smoke-free air laws in workplaces were higher than in restaurants and other indoor public places. The effects of youth access restrictions were greater in the age group <16 years than in the age group 16-17. The stronger the implementation of other measures, the greater the potential short-term effects. A comparison of seven tobacco control measures showed that the cessation treatment programs increase in cessation rate was the highest, 0.404 (95%CI: 0.357-0.456). The reduction in smoking rate and reduction in initiation rate of youth access restrictions strongly enforced and publicized was the highest in the age group <16 years, 0.292 (95%CI: 0.269-0.315), and 0.292 (95%CI: 0.270-0.316). Conclusions: The potential short-term effects of seven tobacco control measures in different scenarios were evaluated more accurately and objectively through Meta-analysis. In the short term, cessation treatment programs will substantially increase smoking cessation rates, and strong youth access enforcement will sharply reduce smoking and initiation rates among adolescents under 16. These results also offer strong data-related support for the simulation and prediction of tobacco control measures in China and other countries.
Adolescent ; Humans ; United States ; Tobacco Control ; Prevalence ; Computer Simulation ; Smoking Cessation ; Health Behavior ; Smoking Prevention